CBD and Naproxen (e.g. Aleve, Naprosyn, Proxen, Naprux)
David ReichUpdated:Key points at a glance:
CBD and naproxen can be used at the same time, but this may not be suitable for everyone. CBD has been reported to interact with certain metabolising enzymes such as CYP2C9 and UGT, which may influence how naproxen is processed in the body. Gastrointestinal discomfort is commonly associated with naproxen use, while bleeding problems are described less frequently. Particular caution is generally advised in people with a history of stomach ulcers, those taking blood thinners, or those with kidney or liver issues, during pregnancy and at an advanced age. If using CBD alongside other medications, it is often recommended to start with a low CBD amount, allow a gap of two to three hours between products, and take naproxen with food. In case of uncertainty, a healthcare professional should be consulted.
CBD and naproxen are often used together for pain or inflammation. For many people this is possible, but it is not suitable for everyone. Key factors include potential CBD–naproxen interactions (via liver enzymes such as CYP2C9 and UGT), the gastrointestinal risks of NSAIDs, and individual aspects such as age, other medicines, and liver or kidney function. If you are unsure, ask a doctor or other healthcare professional to review the combination.
CBD and naproxen can be used together, but the risk of gastrointestinal problems and other side effects may increase in some people. Seek medical advice first if you have stomach issues, take other prescription medicines, or have liver or kidney conditions.
What is naproxen (Aleve, Naprosyn, Proxen, Naprux)?
Uses, mechanism of action, typical dosages
Naproxen is a non-steroidal anti-inflammatory drug (NSAID) used to relieve pain and inflammation. It inhibits cyclo-oxygenase enzymes (COX‑1 and COX‑2) and thus reduces prostaglandin formation. Typical uses include muscular pain, period pain (dysmenorrhoea) and inflammatory joint conditions such as arthritis. Availability and brand names vary by country, including Aleve (particularly in North America), Naprosyn, Proxen and others. In many countries, lower-dose products are available over the counter, while higher strengths are prescription-only. The appropriate dose and duration of treatment should always be determined individually by a doctor.
Common side effects and particular risks
- Gastrointestinal: heartburn, irritation, nausea; less commonly gastritis, ulcers or bleeding.
- Kidneys: NSAIDs can reduce blood flow to the kidneys. The risk is higher in older age, with dehydration, or when used together with ACE inhibitors, ARBs or diuretics.
- Cardiovascular: possible increase in blood pressure and fluid retention.
Important: People with a history of ulcers, active gastrointestinal problems, severe renal impairment or those taking blood-thinning medicines should only use naproxen after medical advice.
What is CBD and how does it work with other medicines?
ECS interaction, forms, dose variability
Cannabidiol (CBD) is a non-intoxicating constituent of the cannabis plant. It interacts with the endocannabinoid system (ECS) as well as other signalling pathways. CBD is available as oils, capsules, sprays or topical products. Individual dosages vary widely; a “start-low-go-slow” approach is commonly recommended. More on how it works: How does CBD interact with the ECS?.
Side effects and metabolic interactions
CBD is mainly metabolised in the liver and may inhibit enzymes including CYP2C9, CYP2C19 and CYP3A4, as well as UGT1A9 and UGT2B7. Because of this, CBD can potentially increase plasma levels of some prescription medicines that depend on these enzymes for their breakdown. Commonly reported side effects include tiredness, dry mouth, dizziness, changes in appetite and occasionally stomach discomfort. Raised liver values have primarily been observed at higher CBD doses and when used together with other medicines that affect the liver. Further background on CBD drug interactions is available here: CBD and medicines: interactions.
CBD is processed in the liver and can inhibit CYP and UGT enzymes involved in drug metabolism. This means interactions with prescription medicines are possible. Side effects are often mild but can vary from person to person and may be more relevant at higher CBD doses.
Can I take CBD and naproxen together?
Using CBD and naproxen together is possible in many situations, but not advisable for everyone. CBD can inhibit liver enzymes (including CYP2C9) and UGT transferases, which may increase exposure to naproxen and other medicines. This could favour gastrointestinal discomfort and, more rarely, complications. Have the combination assessed by a healthcare professional, especially if you have stomach problems, are on blood thinners, or have kidney or liver conditions.
Possible CBD–naproxen interactions and risks
- Increased naproxen exposure: By inhibiting CYP2C9, UGT2B7 and UGT1A9, CBD may slow the breakdown of naproxen. In sensitive individuals this could lead to more gastrointestinal side effects.
- Additive gastrointestinal risks: Gastritis, ulcers or bleeding are possible NSAID-related risks. Caution is particularly important in people with a history of ulcers or gastro‑oesophageal reflux disease (GERD), and when using corticosteroids, anticoagulants/antiplatelet agents, or consuming high amounts of alcohol.
- Kidneys: Naproxen can strain kidney function. The overall risk is higher with dehydration, older age, pre-existing kidney problems, and concurrent use of ACE inhibitors, ARBs or diuretics.
- Central nervous system effects: Dizziness and tiredness from CBD may add to any tiredness or general unwell feeling while on painkillers. Take care when driving or operating machinery, especially at the beginning.
- Blood pressure: NSAIDs can increase blood pressure, while CBD may temporarily lower it. In some people this combination might contribute to orthostatic symptoms such as dizziness on standing up.
CBD may slow the metabolism of naproxen via CYP2C9 and UGT enzymes. Together with naproxen’s own effects, this can increase the likelihood of gastrointestinal problems and other side effects in susceptible individuals, especially at higher doses or with additional risk factors.
Who should avoid combining CBD and naproxen?
- Active or previous stomach or duodenal ulcers, severe GERD
- Treatment with anticoagulants or antiplatelet medicines
- Severe liver or kidney impairment
- Pregnancy or breastfeeding
- Advanced age, frailty or pronounced dehydration
CBD and naproxen compared
| Characteristic | CBD | Naproxen |
|---|---|---|
| Mechanism of action | Interaction with the ECS and other signalling pathways | COX‑1/COX‑2 inhibition → reduced prostaglandins |
| Metabolism | Hepatic; possible inhibition of CYP2C9/2C19/3A4, UGT1A9/2B7 | Predominantly CYP2C9; subsequent glucuronidation (UGT) and renal excretion |
| Main side effects | Tiredness, dizziness, dry mouth, changes in appetite or gastrointestinal function | Gastrointestinal irritation, ulcers or bleeding; kidney strain; increase in blood pressure |
| Typical interactions | May increase levels of sensitive CYP and UGT substrates | Increased gastrointestinal risk with anticoagulants, corticosteroids or alcohol |
Risks of the CBD–naproxen combination – overview
| Risk | Why? | Particularly affected | What to do? |
|---|---|---|---|
| Gastrointestinal discomfort or bleeding | Additive effects plus potentially higher naproxen exposure | History of ulcers, use of anticoagulants, high alcohol intake | Take naproxen with food; discuss possible stomach protection (e.g. PPI) with a doctor; watch for warning signs |
| Kidney function | Typical NSAID-related renal risks | Older adults, dehydrated individuals, ACEi/ARB/diuretic users | Stay well hydrated; watch for signs of kidney problems; seek medical advice if concerned |
| Dizziness or tiredness | Additive effects on the central nervous system | People who drive or operate machinery | Be cautious at the start; check your reaction before driving or using machines |
| Blood pressure fluctuations | NSAIDs may increase blood pressure; CBD may temporarily lower it | People with high blood pressure or orthostatic complaints | Stand up slowly; monitor blood pressure where appropriate; discuss concerns with a healthcare professional |
Practical tips for safer use of CBD and naproxen
- Start with a low CBD dose and increase gradually (start‑low‑go‑slow), especially if you are also using naproxen or other prescription medicines.
- If possible, leave a gap of 2–3 hours between taking CBD and naproxen to reduce overlap in the gut. This does not replace medical assessment of liver enzyme interactions.
- Avoid taking naproxen on an empty stomach. If you have an increased gastrointestinal risk, discuss possible stomach protection (e.g. PPIs) with a doctor.
- Limit alcohol consumption and have any additional blood‑thinning medicines (e.g. aspirin, warfarin) reviewed by a healthcare professional.
- Pay close attention to any new symptoms, particularly during the first 1–2 weeks after starting or changing CBD or naproxen doses.
- For localised problems, topical CBD products may be an option to discuss, as they tend to lead to lower overall systemic exposure.
Warning signs – when to seek medical help
- Black, tar‑like stools or vomiting blood
- Severe or persistent stomach pain
- Yellowing of the skin or whites of the eyes, dark urine, intense itching
- Noticeably reduced urine output, or swelling of legs and feet
- Marked dizziness or fainting
Stop using CBD and naproxen together and seek urgent medical advice if you notice signs of gastrointestinal bleeding, liver problems, kidney issues or severe dizziness. Always involve a healthcare professional before combining CBD with naproxen or other prescription medicines.
Conclusion
Many people may use CBD and naproxen together, but it is important to consider gastrointestinal risks, potential CBD drug interactions via liver enzymes, and individual factors such as age, kidney and liver function, and other prescription medicines. Use low CBD doses to begin with, leave a time gap between CBD and naproxen where possible, and stay alert to warning signs. When in doubt, ask a doctor or pharmacist to review your specific situation.
Disclaimer: This article is for information purposes only and does not replace medical advice. Do not change medicines or dosages without consulting your doctor. No claims are made regarding the treatment or cure of illnesses.